Painful events (crises) in the hands or feet, abdomen, back, or chest are the most common symptom of sickle cell disease. This pain may last from hours to days. Most people with sickle cell disease experience anemia. Symptoms of anemia include feeling weak and tired. People with sickle cell disease can appear pale or washed out, or have a yellowish look to their skin and the whites of their eyes (jaundice).

When a child is born with sickle cell disease, it isn't possible to predict which symptoms will appear, when they will start, or how severe they will be. Most symptoms of sickle cell disease are related to either long-term (chronic) anemia or blood vessels blocked by sickled cells.

Symptoms related to chronic anemia

Most people who have sickle cell disease have at least mild symptoms of chronic anemia, which may include:

• Weakness.
• Tiredness (fatigue).
• Pale appearance.
• Yellowing of the skin and the whites of the eyes (jaundice).
• Shortness of breath, especially when they are active.

Research suggests that infants younger than 2 who have severe anemia, hand-foot syndrome, or both may be more likely to have severe sickle cell disease throughout life.¹ Severe anemia may also raise the chance of a person with sickle cell disease getting high blood pressure in the lungs (pulmonary hypertension), and this can be deadly.²

Symptoms caused by blocked blood vessels

Pain symptoms caused by blocked blood vessels in bones, organs, and other tissues include hours to days of extreme pain (painful events). These painful events account for more than 90% of hospital admissions of adults with sickle cell disease.³ Some people rarely have a painful event, while others have them often; three or more per year is considered severe.

Children between the ages of 6 months and 4 years may have episodes of extreme pain in the hands, the feet, or both (hand-foot syndrome).